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posterior stroke OR cerebellar Stroke OR posterior Infarct

Kristine Ravina, Ben A Strickland, Ian A Buchanan, Robert C Rennert, Paul E Kim, Vance L Fredrickson, Jonathan J Russin
Large, broad-based basilar artery (BA) apex aneurysms involving multiple arterial origins are complex lesions commonly not amenable to direct clipping or endovascular management. BA proximal (Hunterian) occlusion with extracranial-to-intracranial bypass is a supported strategy if one or both posterior communicating arteries are small. Hunterian ligation risks sudden aneurysm thrombosis and thromboembolism in the perforator rich BA apex. There currently exists no guidelines for antiplatelet and anticoagulant therapy following Hunterian ligation for complex BA apex aneurysm treatment...
December 8, 2018: World Neurosurgery
Yasuaki Inoue, Kazuhito Matsuzawa
BACKGROUND: Ischemic symptoms caused by traumatic vertebral artery dissection after cervical maneuvers are treated medically and surgically. This is a report of the infrequently documented occipital to vertebral artery bypass to stop the transient ischemic attacks following traumatic vertebral artery dissection. CASE DESCRIPTION: A 33-year-old man presented with a sudden right posterior neck pain following a sudden neck movement, accompanied by left lower quadrant anopsia and rotational vertigo...
December 6, 2018: World Neurosurgery
Tomoyuki Nagata, Sachiko Hosoyama, Norihiko Shida, Nobuhira Ohori
A 31-year-old woman was admitted to the hospital after several episodes of transient numbness in her fingers and dysarthria. No neurological symptoms and signs were observed in this patient on admission; however, blood tests revealed elevated amylase and immunoglobulin G levels, an increased erythrocyte sedimentation rate, and positive anti-Sjögren's-syndrome (SjS)-related antigen A antibodies. The cerebrospinal fluid examination revealed a slight increase in the cell count and protein content. Diffusion-weighted and fluid-attenuated inversion recovery images on magnetic resonance imaging showed high-signal-intensity lesions in the cerebral white matter and basal ganglia supplied by the left middle cerebral artery...
December 2018: Brain and Nerve, Shinkei Kenkyū No Shinpo
Mustafa Aldag, Cemal Kocaaslan, Mehmet Senel Bademci, Zeynep Yildiz, Aydin Kahraman, Ahmet Oztekin, Mehmet Yilmaz, Tamer Kehlibar, Bulend Ketenci, Ebuzer Aydin
INTRODUCTION: The aim of this study was to determine the outcomes of patients developing ischemic stroke after coronary artery bypass grafting (CABG). METHODS: From March 2012 to January 2017, 5380 consecutive patients undergoing elective coronary surgery were analyzed. Ninety-five patients who developed ischemic strokes after on-pump coronary surgery were included in the study, retrospectively. The cohort was divided into four subgroups [total anterior circulation infarction (TACI), partial anterior circulation infarction (PACI), posterior circulation infarction (POCI), and lacunar infarction (LACI)] according to the Oxfordshire Community Stroke Project (OCSP) classification...
September 2018: Brazilian Journal of Cardiovascular Surgery
Feng Wang, Xiao-Yun Hu, Tao Wang, Xiang-Ming Fang, Zheng Dai, Dao-Liu Guo, Xu-Qiang Mao, Zhi-Ming Cui
This study aims to analyze the clinical and imaging features of vertebrobasilar dolichoectasia (VBD) combined with posterior circulation infarction, and to explore risk factors for the occurrence of posterior circulation infarction in VBD patients.VBD patients were divided into 2 groups, according to the results of the imaging examination: posterior circulation infarction group and nonposterior circulation infarction group. The demographics, vascular risk factors, imaging, and other clinical data of the VBD patients were collected and retrospectively compared, and the risk factors for the occurrence of posterior circulation infarction in VBD patients were analyzed...
November 2018: Medicine (Baltimore)
Dimitri Tsialtas, Maria Giulia Bolognesi, Stephania Assimopoulos, Riccardo Volpi, Roberto Bolognesi
BACKGROUND: We aimed to depict the electrocardiographic and echocardiographic aspects in patients before elective major vascular surgery. METHODS: We evaluated through standard 12 lead electrocardiography and transthoracic echocardiography 469 patients with asymptomatic large abdominal aortic aneurysm (AAA), 334 with critical carotid stenosis (CAS), and 238 with advanced peripheral artery disease (PAD) before surgical revascularization. RESULTS: Patients with AAA were predominantly males (p < ...
December 3, 2018: Acta Cardiologica
Johanna E Bischof, Christine I Worrall, Stephen W Smith
OBJECTIVE: In the presence of inferior myocardial infarction (MI), ST depression (STD) in lead I has been claimed to be accurate for diagnosis of right ventricular (RV) MI. We sought to evaluate this claim and also whether ST Elevation (STE) in lead V1 would be helpful, with or without STD in V2. METHODS: Retrospective study of consecutive inferior STEMI, comparing ECGs of patients with, to those without, RVMI, as determined by angiographic coronary occlusion proximal to the RV marginal branch...
November 2018: Journal of Electrocardiology
(no author information available yet)
OBJECTIVECerebral venous sinus thrombosis (CVST) is a known complication of surgeries near the major dural venous sinuses. While the majority of CVSTs are asymptomatic, severe sinus thromboses can have devastating consequences. The objective of this study was to prospectively evaluate the true incidence and risk factors associated with postoperative CVST and comment on management strategies.METHODSA prospective study of 74 patients who underwent a retrosigmoid, translabyrinthine, or suboccipital approach for posterior fossa tumors, or a supratentorial craniotomy for parasagittal/falcine tumors, was performed...
October 1, 2018: Journal of Neurosurgery
Junji Uno, Katsuharu Kameda, Ryosuke Otsuji, Nice Ren, Shintaro Nagaoka, Kazushi Maeda, Yoshiaki Ikai, Hidefuku Gi
BACKGROUND: It is debatable whether mechanical thrombectomy has benefits in a real-world setting outside the more rigid and selective clinical trial environment. OBJECTIVE: To evaluate clinical outcomes, efficacy, and safety of mechanical thrombectomy in single-center retrospective cohort case series. METHODS: We reviewed prospectively collected data from our large-vessel occlusion stroke database to identify patients undergoing mechanical thrombectomy using Penumbra catheters (Penumbra, Almeida, California) as first-line devices...
November 28, 2018: Operative Neurosurgery (Hagerstown, Md.)
Q I Talukder, M H Rahman, A K Azad, M Z Rahman, P K Chanda, F Ahmed
To review the experience of surgical repair of post-infarction ventricular septal rupture (VSR) and analyze the associated outcomes in National Heart Foundation Hospital & Research Institute (NHFH & RI). This retrospective review was performed on 19 consecutive cases who had undergone surgical repair of post-infarction VSR between 2009 and 2017. Continuous variables were summarized as mean plus/minus the standard deviation or median. Categorical variables were expressed as percentage of the sample. Comparison between in-hospital survivors versus non-survivors was performed by Student's t-test and chi-square or Fisher's exact test for continuous and categorical variables respectively...
October 2018: Mymensingh Medical Journal: MMJ
Motomi Arai
We present the unique case of a patient with lumbosacral radiculoplexus neuropathy (LRPN) and a small intramedullary lesion, probably an infarction, in the spinal cord. A previously healthy 58-year-old female developed acute severe pain involving the entire right lower limb, followed by weakness of the right lower limb a few hours later. The patient could not walk and was referred to our clinic. The patient reported no sphincter symptoms. Examination of the cranial nerves and upper limbs revealed no abnormalities...
November 29, 2018: Rinshō Shinkeigaku, Clinical Neurology
(no author information available yet)
OBJECTIVEOcclusive treatment of posterior communicating artery (PCoA) aneurysms has been seen as a fairly uncomplicated procedure. The objective here was to determine the radiological and clinical outcome of patients after PCoA aneurysm rupture and treatment and to evaluate the risk factors for impaired outcome.METHODSIn a retrospective clinical follow-up study, data were collected from 620 consecutive patients who had been treated for ruptured PCoA aneurysms at a single center between 1980 and 2014. The follow-up was a minimum of 1 year after treatment or until death...
October 1, 2018: Journal of Neurosurgery
(no author information available yet)
OBJECTIVEMorbidity and mortality in patients with posterior circulation stroke remains an issue despite advances in acute stroke therapies. The intravenous infusion of mesenchymal stem cells (MSCs) elicits therapeutic efficacy in experimental supratentorial stroke models. However, since there are few reliable animal models of ischemia in the posterior circulation, the therapeutic approach with intravenous MSC infusion has not been tested. The objective of this study was to test the hypothesis that intravenously infused MSCs provide functional recovery in a newly developed model of brainstem infarction in rats...
October 1, 2018: Journal of Neurosurgery
Won-Bae Seung
A proximal occluded vertebral artery (VA) with reconstitution by muscular collateral vessels is a relatively common finding. However, due to inadequate intracranial anastomosis and hypoplasia or stenosis of the opposite VA, a number of patients develop symptoms of brain ischemia. In the current case, a 63-year-old man presented with repeat neurological symptoms such as dizziness, nausea, vomiting, dysarthria, left hemiparesis, and right hemianopsia. Magnetic resonance imaging revealed multiple posterior infarctions...
September 2018: Case Reports in Neurology
Sang Hun Lee, Jae Hyung Cha, Il Eok Jung, Sung Wook Yu, Ju Sun Moon, Kyung Hee Cho, Kyung Mi Oh, Chi Kyung Kim, Jin-Man Jung
BACKGROUND: In patients with unilateral posterior inferior cerebellar artery (PICA) territory infarction, the absence of relevant vessel stenosis may make it difficult to determine the etiology of the infarction. The incidence of cardioembolic (CE) infarction and the factors associated with infarction in such patients remains largely unknown. We hypothesized that the PICA angle would affect the flow direction of embolic sources. Thus, we analyzed the association between high-risk CE sources and the PICA angle...
November 24, 2018: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
Shashank Agarwal, Breehan Chancellor, Jonathan Howard
Bilateral thalamic strokes due to Artery of Percheron (AOP) occlusion are rare but have been previously reported in the literature. It is due to a rare anatomic variant where a solitary arterial trunk from the proximal segment of either posterior cerebral artery (PCA) supplies bilateral thalami and midbrain. Despite its description in the literature, these strokes are usually missed and patient's symptoms are not thought to be secondary to a vascular etiology. Through this report we aim to describe the clinical and radiographic features seen in these patients...
November 21, 2018: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
Yuka Terasawa, Ayumi Arai, Kenichiro Sakai, Hidetaka Mitsumura, Yasuyuki Iguchi
Reversible cerebral vasoconstriction syndromes (RCVS) have been well recognized recently as one cause of cerebrovascular disease, but the time course of vessel vasoconstriction remains uncertain. We report herein 2 cases with RCVS in which we clarified temporal changes in vessel vasoconstriction in detail using transcranial color-coded sonography (TCCS). The first case involved a 27-year-old woman who developed intracerebral hemorrhage (ICH) and subarachnoid hemorrhage (SAH) after severe headache. TCCS showed peak systolic velocity (PSV) in the left middle cerebral artery (MCA) peaked at 212 cm/s on day 6 and gradually decreased, whereas PSV of the left posterior cerebral artery (PCA) and left anterior cerebral artery (ACA) re-elevated to 190 cm/s on day 15...
November 20, 2018: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
Joji Inamasu, Shunsuke Nakae, Yoko Kato, Yuichi Hirose
Objectives and Background: Arterial dissection (AD) of the vertebral artery (VA) or its branches may cause ischemic stroke of the posterior circulation. However, clinical and radiological characteristics of patients with AD-related cerebellar infarction (CI) have rarely been reported. Methods: Forty-nine patients with CI admitted to our department from April 2008 to March 2015 were identified from our database. After dichotomization into the AD and non-AD group, their demographics and presenting symptoms were compared...
October 2018: Asian Journal of Neurosurgery
Imama Naqvi, Alexis N Simpkins, Kaylie Cullison, Emily Elliott, Dennys Reyes, Richard Leigh, John K Lynch
Lacunar strokes account for about a fourth of all ischemic strokes. Pontine infarcts often present with stuttering symptoms, referred to as pontine warning syndrome (PWS). Patients presenting with fluctuating symptoms can appear to have rapidly improving symptoms and thus often go untreated despite the risk of recurrent deficits. MRI carries a higher sensitivity in detecting posterior circulation strokes compared to computed topagraphy, but does not always indicate irreversible injury. Here we present the first description of a stuttering lacune, captured radiographically on serial magnetic resonance imaging (MRI), that was initially averted with the administration of intravenous (IV) tissue plasminogen activator (tPA), only to return a month later and progress on imaging despite re-administration of tPA...
December 2018: ENeurologicalSci
Tuğçe Aksu Uzunhan, Nur Aydinli, Mine Çalişkan, Burak Tatli, Meral Özmen
BACKGROUND: Our aim is to retrospectively assess short-term neurological outcomes in pediatric stroke with patient features. METHODS: Children aged 28 days-18 years with arterial ischemic stroke (AIS), cerebral sinovenous thrombosis (CSVT), and hemorrhagic stroke (HS) between 2007 and 2013 were evaluated. Neurological findings within the first three months were accepted as short-term prognosis and modified Rankin scale was used. RESULTS: In the study, 33 patients (62%) with AIS, 12 (23%) with HS, and 8 (15%) with CSVT were included...
November 18, 2018: Pediatrics International: Official Journal of the Japan Pediatric Society
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